U.S. patent number 3,629,594 [Application Number 05/029,041] was granted by the patent office on 1971-12-21 for patient-position-monitoring method and system for use during medical diagnostic and therapeutic procedures.
This patent grant is currently assigned to Michael Reese Hospital and Medical Center. Invention is credited to Glen Sandberg.
United States Patent |
3,629,594 |
Sandberg |
December 21, 1971 |
**Please see images for:
( Certificate of Correction ) ** |
PATIENT-POSITION-MONITORING METHOD AND SYSTEM FOR USE DURING
MEDICAL DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Abstract
A light beam is directed upon a retroreflective element, located
adjacent the pertinent portion of the patient's body and is
reflected upon a photocell or some other photoresponsive means. If
there is any appreciable change in the patient's position, the
signal from the photocell will change. The changed signal can be
employed to perform a control function, such as actuating a warning
device, or terminating the diagnostic or therapeutic procedure, so
that the radiation will not be misdirected. The light beam is
preferably produced by an optical system comprising a lamp, an
apertured member to produce a small spot of light, a partially
light-transmitting mirror, and a lens for focusing the beam upon
the retroreflective element. The reflected beam is preferably
focused by the lens through the mirror and upon the photocell. The
retroreflective element is preferably in the form of a small piece
of retroreflective adhesive tape, to be stuck to or adjacent to the
patient's body.
Inventors: |
Sandberg; Glen (Chicago,
IL) |
Assignee: |
Michael Reese Hospital and Medical
Center (N/A)
|
Family
ID: |
21846908 |
Appl.
No.: |
05/029,041 |
Filed: |
April 16, 1970 |
Current U.S.
Class: |
378/95; 250/221;
378/98; 378/117; 378/206; 600/595; 600/407; 601/15 |
Current CPC
Class: |
A61B
6/08 (20130101); G05D 3/125 (20130101); A61N
5/1049 (20130101); A61N 2005/1056 (20130101) |
Current International
Class: |
A61B
6/08 (20060101); A61N 5/10 (20060101); G05D
3/12 (20060101); G03b 041/16 () |
Field of
Search: |
;250/65,93,95,103,216,217,221,222,224 ;128/21R,2.1A,24.1 |
References Cited
[Referenced By]
U.S. Patent Documents
Other References
willis, G. R.; IBM Technical Disclosure Bulletin; Vol. 6, No. 6;
Nov., 1963; pp. 13; 250-221..
|
Primary Examiner: Birch; Anthony L.
Claims
What is claimed is:
1. In combination with a radiation source to be used with a patient
in a medical therapeutic or diagnostic procedure, a
patient-position-monitoring system comprising a retroreflective
element adjacent the pertinent portion of the patient's body, a
remote source for directing a beam of light upon said
retroreflective element, said light beam being reflected by said
element, photoresponsive means for remotely receiving the reflected
light beam from said element to develop a signal indicative of any
medically significant change in the position of the patient, and
means responsive to said signal for signalling said change in
position.
2. A system according to claim 1, in which said retroreflective
element comprises a piece of retroreflective material having an
adhesive backing for securing said material to the pertinent
portion of the patient's body.
3. A system according to claim 1, in which said light beam source
includes a lamp, an apertured member restricting the light from
said lamp to a small spot, and means for focusing said small spot
upon said retroreflective element.
4. A system according to claim 1, in which said light beam source
comprises a laser beam source.
5. A system according to claim 1, in which said light beam source
includes a light-emitting diode, and means for focusing the light
beam from said diode on the retroreflective element.
6. A system according to claim 3, in which said focusing means
comprises a mirror and a lens, said mirror being disposed at an
oblique angle to the optical axis of said lens.
7. A system according to claim 6, in which said photoresponsive
means comprising a photosensitive device disposed behind said
mirror, said mirror being partially light-transmissive, the
reflected light beam being adapted to be focused by said lens,
through said mirror and upon said photosensitive device.
8. A system according to claim 1, in which said light beam source
includes means for developing a small spot of light, and a
partially light-transmissive mirror and a lens for projecting said
spot upon said retroreflective element, the reflected light beam
being adapted to be projected upon said photoresponsive means
through the agency of said lens and said mirror.
9. In the combination of claim 1 in which said radiation source
remotely produces a radiant energy beam directed toward the
patient, and said means responsive to said signal controls said
radiation source.
10. In the combination of claim 9, wherein said controlling means
is adapted to deactivate said radiation source.
11. In the combination of claim 9, wherein the retroreflective
element is secured to the patient.
12. A system according to claim 9, in which said light beam source
includes means for developing a small spot of light, and a
partially light-transmissive mirror and a lens for projecting said
spot upon said retroreflective element, the reflected spot of light
being adapted to be projected upon said photoresponsive means
through the agency of said lens and said mirror.
13. In the combination of claim 12 in which said lens is an axicon
lens.
14. A patient position monitoring system for use during a medical
procedure involving the exposure of a patient to radiation and for
controlling a radiation source comprising: a radiation source, a
retroreflective element to be mounted closely adjacent the
pertinent portion of the patient's body to be exposed to said
radiation, a light source for directing a beam of light upon the
retroreflective element, said light beam being reflected by said
element, photoresponsive means for receiving the reflected light
beam from said retroreflective element to develop a signal
indicative of any substantial change in the position of the patient
from a first position, and means connected between said
photoresponsive means and said radiation source and operative to
deactivate said radiation source in response to a change in the
signal from said photoresponsive means.
15. A method of sensing medically significant changes in the
position of a patient during a medical radiant energy exposure
procedure, comprising the steps of mounting a retroreflective
element adjacent the patient's body, remotely directing a beam of
light upon the retroreflective element, and remotely directing the
resulting reflected light beam from the retroreflective
element.
16. A method according to claim 15, comprising the further step of
performing a control function in response to a change in the
reflected light beam.
17. A method according to claim 15, comprising the further step of
producing a warning signal in response to a change in the reflected
light beam.
18. A method according to claim 15, comprising the further step of
discontinuing the medical procedure in response to a change in the
reflected light beam.
19. A method of responding to a medically significant change of
position of a patient during a medical procedure comprising the
steps of providing a retroreflective element in a fixed relation
adjacent the pertinent portion of the pateint's body, directing a
beam of light from a remote position toward the retroreflective
element, remotely detecting the reflected beam of light from said
retroreflective element, producing a warning signal in response to
a medically significant change of position of the patient from a
first position to another position, and discontinuing the medical
procedure in response to said warning signal.
20. A method according to claim 19, comprising the further steps of
beaming radiant energy toward the patient, and discontinuing said
beaming in response to the signal.
21. A method according to claim 20 in which the retro-reflective
element is mounted on the patient.
Description
This invention relates to a method and system for indicating any
appreciable change in the position of a patient during medical
procedures utilizing a high-energy beam source such as radiography,
radioisotope or ultrasonic scanning, radiation therapy, laser beam
treatment or the like, or utilizing a high-energy source. Any
change in the position of the patient is undesirable, because such
change may cause the high-energy beam or radiation to be
misdirected, or because inaccurate sensing of the high-energy
source may give false data.
A misdirected radiation therapy beam may have serious effects on
the intended cure of the patient. All high-energy beams such as
radiation beams must be considered as potentially harmful, even at
levels used in diagnostic procedures, and a misdirected diagnostic
beam will usually necessitate a repeat procedure. By reducing the
number of these repeats, the system will achieve the goal of
reducing unnecessary exposure of patients in diagnostic procedures
utilizing X-rays or radioactive isotopes, as well as in therapy
procedures.
The method and system of the present invention may be employed to
perform a control function, such as producing a warning signal, or
shutting off the source of radiation or source of other high-energy
beam. In either case, the operator will reposition the patient
before continuing the procedure.
It is an object of the present invention to produce a monitoring
system which is reliable and highly effective, and easy to use in
the presence of normal room light.
Thus, the present invention preferably involves directing a light
beam upon a retroreflective element, associated with, mounted on,
or adjacent the pertinent portion of the patient's body. The light
beam is reflected upon a photocell or some other photoresponsive
means. If there is any appreciable movement of the patient's body,
the signal from the photocell or other photoresponsive means will
be changed, or will otherwise indicate the change of position or
movement. Such signal is preferably fed through an amplifier to a
relay which can actuate a warning device, and can also, if desired,
control or turn off the X-ray tube or any other source of radiation
or high energy.
The retroreflective element is preferably in the form of a small
piece of retroreflective adhesive tape or other similar sheet
material. In this way, the retroreflective element can easily be
applied to a pertinent portion of the patient's body.
The light source preferably comprises a lamp, an apertured member
to produce a small spot of light from the lamp, and an optical
system for focusing the beam upon the retroreflective element. Such
an optical system preferably comprises a partially
light-transmissive mirror and a lens. The reflected beam is
preferably focused by the same lens, through the mirror and upon
the photocell.
The signal from the photocell is preferably fed through an
amplifier to a relay which may perform various control functions,
such as actuating a warning device or turning off the source of
radiation, or both.
Further objects, advantages and features of the present invention
will appear from the following description, taken with the
accompanying drawings, in which:
FIG. 1 is a diagrammatic elevation of a patient-position-monitoring
system, to be described as an illustrative embodiment of the
present invention.
FIG. 2 is an elevational view, partially in section of the optical
system of FIG. 1.
FIG. 3 is a block diagram of the electrical system of FIG. 1.
As shown in FIG. 1, the invention is embodied in a monitoring
system 10, comprising a retroreflective element 12, mounted on the
pertinent portion of the patient's body 14. Preferably, the
retroreflective element 12 takes the form of a small piece of
retroreflective tape or other sheet material, with adhesive
material on the back side thereof, so that the element 12 can
easily be stuck to the patient's body. The adhesive material is
preferably of the pressure sensitive, permanently tacky tape.
The retroreflective element 12 is preferably applied to the
patient's body at or near the site of the patient's exposure to
radiation. If the patient is immobilized, then the element 12 may
be applied to the table or couch to which the patient is fixed. The
size of the retroreflective element is chosen according to the
required tolerance for displacement of the patient. Thus, any
movement of the retroreflective element out of the light beam will
indicate that the irradiated portion of the patient's body has
moved more than a prescribed amount.
A light beam 16 is projected upon the retroreflective element 12
and is reflected back by the element. The material of which the
retroreflective element is made has the characteristic that any
impinging light beam is reflected directly back, along its path of
impingement, even if the surface is not normal to the path of
impingement of the light beam. Such a material is available from
the 3M Company and has been used for making reflective highway
signs and the like.
A retroreflective target with the coaxial light source and detector
described herein achieves a high contrast between the target and
the background in the presence of normally encountered ambient
light.
The light beam is produced and is also utilized by an optical unit
18, shown in section in FIG. 2. The light is produced by a lamp 20
and is directed through a small aperture 22 in a plate 24 or the
like. In effect, a small spot of light is produced at the aperture
22. The lamp 20 is mounted in a housing 26.
The small spot of light is projected upon the retroreflective
element 12 by a mirror 28 and a lens 30, mounted in a tubular
housing 32. The mirror 28 is at an oblique angle to the optical
axis of the lens 30, so that the lamp 20 and the apertured plate 24
can be disposed laterally from the axis of the lens. As shown, the
light beam is reflected at an angle of about 90.degree. by the
mirror 28. The lens 30 focuses the light beam so as to produce an
image of the small spot of light, on the retroreflective element
12. Although a lens such as that illustrated in the drawings will
function satisfactorily, an axicon lens system will perform in a
superior manner in this application. Axicon lenses are described in
U.S. Pat. No. 2,759,393, and are used in coaxial light-emitting
systems. In the present invention and axicon lens achieves a sharp
focus over an extended distance to enhance the utility of the
system.
The light beam is reflected back through the lens 30 by the element
12 and is focused upon photoresponsive means, illustrated as
comprising a photosensitive device such as photocell 34, disposed
behind the mirror 28. While the mirror could be apertured, it is
preferably of the type having a reflective coating which is
partially light-transmissive. Thus, the reflected beam is able to
pass through the mirror to the photocell 34. It will be understood
that the photocell 34 may be of any suitable type, such as a solid
state photodiode.
The reflective element 12 is of small size so that any appreciable
or medically significant movement by the patient will move the
element 12 out of the path of impingement of light beam 16, hence
will cause a change in the amount of light reflected to the
photocell 34. That is because the retroreflective element will be
moved out of the path of the beam of light and thus the light beam
will not be reflected back to the photocell. As such, the
electrical signal produced by the photocell 34 will exhibit a
corresponding change.
As shown in FIG. 3, the output signal from the photocell is
preferably fed into an amplifier 36 which produces a corresponding
amplified output, adapted to operate a control relay 38 or the
like. The control relay 38 may be arranged to perform various
control function, such as actuating a warning device 40, when the
reflected light beam is diminished in magnitude by movement of the
patient. The control relay 38 may also be arranged to shut off or
deactivate the radiation source, shown as an X-ray tube 42. It will
be understood that the radiation source may comprise any other
suitable means for producing radiation, such as an atomic
irradiator utilizing radioactive cobalt, for example, or may
comprise other means for producing a high-energy beam, such as a
laser beam, for example.
The optical unit 18 may have a swivel mounting bracket 44 which
provides for universal adjustment, so that the light beam can
easily be aimed at the retroreflective element 12. The bracket 44
is secured to a wall 46 or any other suitable support. In some
cases, the optical unit may be mounted on the carriage which
supports the X-ray tube 42. The unit may also be mounted rigidly in
the room or affixed to the equipment to serve as a pointer for
positioning the patient.
In the operation of the patient position monitoring system, the
retroreflective element 12 is mounted on the patient's body, at or
near the intended site of the diagnostic procedure or therapy. When
the patient has been properly positioned, the light beam 16 is
aimed so that it falls directly upon the retroreflective element
12. The medical procedure is then commenced.
If the patient moves appreciably, the reflected light, projected
upon the photocell 34, diminishes. The resulting signal produced by
the photocell may be amplified by amplifier 36, and is employed to
actuate the warning device 40, and also preferably to deactivate
the X-ray tube 42 or other high-energy beam source. The warning
device 40 may comprise a buzzer, bell, lamp or the like. In
response to the warning, the operator repositions the patient so
that the procedure can be completed.
The monitoring system is applicable to certain types of diagnostic
X-rays, to X-ray therapy, and to other radiation and high-energy
source therapy and diagnostic procedures. Thus, the high-energy
source may be a remote beam source, or, for example, a radioactive
source administered to the patient, the emission of which is
scanned and detected externally of the patient in a known manner.
Indeed the system may utilize the eye as the retroreflective
element in certain diagnostic and therapeutic procedures.
It will be recognized that the patient position monitoring system
is highly reliable and effective, yet is easy to use.
Various modification, alternatives and equivalents can be employed.
Thus, for example, it is possible to interchange the positions of
the photocell 34 and the lamp 20, with its apertured plate 24.
Further a concave mirror or mirrors may be used for focusing the
emitted and reflected light beams, instead of a lens or lenses.
Also, for example, a continuous laser or a light emitting diode can
be used for the light beam source. Such a diode is essentially a
point source of light, which can be focused by means of a lens upon
the retroreflective element. An optical system is used in
connection with the laser, to form a narrow beam of light. The
retroreflective element may comprise a corner reflector of mirrors,
prisms or transparent jewels, to be attached to the patient's
body.
* * * * *